Objective: Through the monitoring of patients with PD during ON and OFF states, we aim at studying the detection of nonmotor symptoms (NMS) changes during motor signs assessment.

Background: NMS and fluctuations represent a heavy burden in PD patients and are often under-recognized and properly considered for treatment adaptation. Among NMS, dysautonomic manifestations like cardiac frequency or blood pressure are monitored by continuous objective measures. Respiratory signs are less commonly reported. In general, only discrete measures of ventilation are performed at rest. Ventilatory polygraphs are used for sleep apnea diagnosis. They compute activity, respiratory inductive plethysmography measures, nasal pressure, cardiac frequency and pulse oximetry. Previous studies have shown that they can be used during mild activities. Such devices may be easily used with sensor-based motor assessment to study dysautonomic signs in PD. Thus, this body-worn sensors combination could allow identifying changes of respiratory pattern in PD patients assessed for motor symptoms in ON and OFF states.

Methods: 30 patients with PD will be included in the study and recruited during a scheduled in-hospital stay in a French tertiary referral center for PD (Pitié-Salpêtrière, Paris). Continuous measures of ventilation will be performed during acute levodopa tests in ON and OFF states by a ventilatory polygraph device (NOX A1, Noxmedical). Patients will be asked to carry out typical walk tests. Data obtained from the movements signals will enable evaluation of ventilatory parameters. An associated pulse oximeter will allow collection of cardiac frequency and oxygen saturation. Evaluations of NMS will then be compared to motor scores and patients’ agenda. Other comparison will be made with continuous movement monitoring obtained via wearable sensors that are validated for objective motor symptoms assessment.

Results: Participation of patients will enable providing results in July 2018. Expected results are: 1. to identify a respiratory signature of OFF or ON non-motor state and 2. to study its correlation to OFF or ON motor state to link motor and non-motor assessment.

Conclusions: Results will address a global view of the impact of OFF and ON state on motor and non-motor symptoms with wearables. This innovative continuous monitoring may improve PD knowledge, which may lead to a new approach for patients’ clinical assessment and care.

References: Retory, Y., Niedzialkowski, P., de Picciotto, C., Bonay, M., & Petitjean, M. (2016). New respiratory inductive plethysmography (RIP) method for evaluating ventilatory adaptation during mild physical activities. PloS one, 11(3), e0151983.

« Back to 2018 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/accelerometer-based-measures-and-analyses-of-nonmotor-symptoms-of-patients-with-parkinsons-disease/